Tag Archives: prevention

A PATIENT ASKS: “WHAT DO I DO ABOUT THE RECENT MEASLES OUTBREAK AT DISNEYLAND AND BEYOND?”

Chemodanchik_002_p(0).jpgWhat do I do about the recent measles outbreak at Disneyland?  Does it affect me in any way?  I’m concerned as the news continues to report about it…..BSL

MY RESPONSE:

Measles is a highly contagious virus characterized by fever, rash, and often pneumonia.  It has been virtually eliminated from the United States through widespread vaccination of children at age 15 months.  This immunization occurs in the form of the MMR immunization (Measles, Mumps, Rubella) and is performed as a 2-shot series.

You are considered immune to measles and unable to be reinfected if:

1.  Your were born before 1957.  (Virtually all people born before 1957 were exposed to measles as it was prevalent in all areas of the counter, and occurred in epidemics in many years prior to that date.)

2.  You had documented measles.  (Many people do not recall such a history, so this is often not a helpful marker.  Still, some people are aware of having been definitely ill with measles.)

3.  You were born after 1967 and received the two shots of MMR (live) vaccine.  (Virtually all people who lived in the US, and were born after 1967 were given the MMR vaccine in the appropriate interval and dosing, unless they know that their family was trying to avoid immunization.)

4.  You have had a blood test that is positive for Rubeola (measles) IgG. (This proves immunity to measles.)

 

Anyone born in the US between 1958 and 1967  likely received the inactivated (dead) measles vaccine, and this was known to be less effective than the modern live MMR.  They are likely to be immune to measles, but to prove immunity, a measles (Rubeola) IgG blood test can be done to be certain.  These people likely are safe, but blood testing is sensible if concerned.

 

 

 

 

WALK AND STAY HEALTHY

muscles flexI’m a big fan of exercise and feel very strongly that it is the single most important effort you should make to stay healthy.  A patient recently sent me this article on a study from the LIFE trial (Standing for Lifestyle Interventions and Independence for Elders).

In a study of over 1,500 patients, it showed that ‘at risk’ older patients benefited from a directed walking and exercise program to reduce their risks of debilitation and need of assistance.

So don’t delay your plans to become more active.  There are benefits to be had, and in particular it is one of your keys to maintaining an independent lifestyle.

 

MICE AND PROZAC….MAKE A GREAT COMBINATION

love yeWhy would you give mice Prozac?  Well……not to improve their moods.   Have you ever seen a depressed mouse???  I didn’t think so.

Researchers used Citalopram (a medication quite similar to Prozac as it is an SSRI….Selective Serotonin Uptake Inhibitor) in mice to see if this reduced the production of Beta-Amyloid protein in their brains, as this protein over-production and accumulation is strongly associated with the development of Alzheimer’s Disease.   Citalopram strongly reduced the accumulation of this protein, and in human volunteers, it reduced the amount of Beta-amyloid protein found in the cerebrospinal fluid.

Could Prozac and similar medications help prevent Alzheimer’s disease?  This data is suggestive, but further studies will be required to further elucidate the connection.  In the meanwhile, patients on these medications can take some comfort in the idea that they are getting protections while also treating their mood and anxiety symptoms.  Rather than worrying ‘what is the medication doing to harm me’, it’s nice to think that such medications may be providing additional benefits beyond what we imagined.

 READ MORE>>>>>HERE

 

 

 

CANARY IN THE COAL MINE

stethascopeI always liked that saying about the canary.  Perhaps it wasn’t such a good job being the canary, but the idea of a simple measure to assess a situation is a great idea, and the latest information on diabetic patients gives us just such information.

Diabetic complications have fallen sharply over the past few decades, and this is due to progress in medicine.  Specifically it relates to reducing cholesterol and blood pressure.  There is some help from reduction in blood sugar, but the lion’s share of the reduced complications in diabetes are related to our ability to modify those aspects of diabetes that many of us share in common:  High Cholesterol and High Blood Pressure.

The modern area (past 30 years) have seen the advent of an array of medications that have changed the health of America.  They are:  Cholesterol mediations (statins) and ACE Inhibitors (blood pressure medications that are good for heart and kidneys).

So, if you have any question about the benefits of these medication, any many people do, we can look at the population of diabetic patients.  They are the ‘canaries’ as they will be the first to show issues, and the data is clearcut….these medications are preventing illness, making lives better, and making them longer.

Read more >>>>>>>HERE

MY VITAMIN RECOMMENDATIONS FOR SPECIFIC CONDITIONS

balloonsAs most of you know, I am not a huge proponent of vitamins, based on concerns about the potential negatives they can cause,  as well as the lack of evidence for their general effectiveness.

That said, there are situations in which vitamins can be considered and here is a list of my current recommendations, with particular brands mentioned (that are known to be of high quality.  Other brands may be fine, but these are the ones I am comfortable with.)

Bones (documented osteoporosis with added Vitamin D required.)

Natural Factors Vitamin D3 (1000, 2000, 5000 unit capsules)

Calcium Citrate…..Citrical Brand (all varieties)

 

Memory Loss (ALZHEIMER’S DISEASE):

Nature Made Vitamin E 1000 unit capsules, 2 daily

B Vitamins (folic acid & B-12) in the form of Xymogen Methyl Protect, 1 daily (we have this at our office)

 

Fatty Liver (ALSO CALLED NASH…NON-ALCOHOLIC STEATOHEPATITIS):

Nature Made Vitamin E 400 units capsules, 2 daily

 

Hair Loss (Alopecia)

Nature Made Biotin 2500mcg

Natural Factors Easy Iron, 20mg tablets, 1-2 daily

 

Iron Deficiency Anemia:

Natural Factors Easy Iron, 20mg tablets, 1-4 daily (easiest on the digestion)

Ferro Sequels (Ferrous Fumarate), slow release iron, 1-4 per day

Iron Sulfate 325mg, 1-3 per day

EVERYTHING IN MODERATION

dreamstime_l_5740056That simple admonition, best captures my sense of the ‘science’ of diet and how to eat properly for your health.    There are advocates for every  type of diet….low calorie, low fat, low sugar.  All have their advocates and their detractors, and all have some supportive research as backing, but there will be NO definitive answer to this question.

A recent study cited in the NY Times was brought to my attention by a patient, and this study showed that saturated fats, long the villian of the American diet, have now been given some cover.    In a article in the ANNALS OF INTERNAL MEDICINE  >>>HERE<<<   did not find an association between heart disease and saturated fat consumption, nor did they find a reduced level of heart disease in those who has unsaturated or monounsaturated fats.

While this is good news for those of use who like our burgers, it just shows that the complex connection between diet and health is so multifaceted, that eating with moderation, both those items claimed to be ‘healthy’ and those unhealthy, will likely yield a fine, and long life.   Keep your processed foods to a minimum, eat appropriate portions, exercise (don’t forget that….#1 KEYS recommendation), and keep your weight from ballooning and you’ll stay healthy.

 

CAN EXERCISE PREVENT INFECTIONS….A PATIENT MAKES HIS CASE

Chemodanchik_002_p(0).jpgBelow is a email from a patient touted his good health since beginning a stronger exercise regimen.  He not only made the point that he felt better, but that he feels it prevents him from getting run-of-the mill infections, a particularly nice effect this time of year when the ‘cold season’ is heavy.  He bolstered his comments with some science as well and I wanted to share this with other patients.
Hi Doc,

Earlier today I mentioned to you that I had not had a cold since I began exercising almost daily in Feb. 2012.  There is good evidence that exercising 30 minutes, 5 times a week reduces the number and severity of colds. That’s another perk to what you recommend.

A couple of short paragraphs from an article about the study:
The researchers found that the frequency of colds among people who exercised five or more days a week was up to 46% less than those who were largely sedentary — that is, who exercised only one day or less of the week.
In addition, the number of days people suffered cold symptoms was 41% lower among those who were physically active on five or more days of the week, compared to the largely sedentary group. The group that felt the fittest also experienced 34% fewer days of cold symptoms than those were felt the least fit.
Moreover, colds also appeared to be less severe for those in better shape. Among those who felt the fittest, the severity of symptoms dropped by 32% and by 41% among those who exercised most, the researchers note.
Before 2012, I exercised 3 times per week and had one or two colds per year. I cannot remember ever going two full years without catching a cold prior to the last two years. You may want to share this with your patients. I mentioned the study to my friend who teaches Management at ASU and is an avid runner. He told me that he had not had a cold in years and was exposed to lots of students with colds.
Best,
M

GET OFF YOUR DUFF

wink of chihuahuaPhysical activity is the #1 Key to health….just check out THE KEYS, and you’ll find it right there at the top.   You can take inactivity to a new high (or should I say low), and be so inactive that you actually get  SITTING DISEASE.

We are sitting too much and this is making us weak and prone to illness, so say researchers in the Journal of Physical Activity and Health.   Sitting too much can lead to illness, included heart disease and diabetes, and also leads to disability and lack of independence later in life.

What can you do to prevent this from happening to you?  One of the researchers offers these suggestions for replacing some sitting time with light activity:

• If you are watching TV, get up and walk around the house when a commercial comes on.

• When you are working in front of a computer, get up and walk around every hour.

• When you go to grocery store or mall, park in a space that is far away.

• When you get up to have glass of water or for a meal, walk around the house or office.

• Take the stairs instead of the elevator, if you are able.

Read   more HERE

CAUTION ADVISABLE WHEN TREATING INCIDENTAL SCAN FINDINGS

lightbulbWith the progressive improvement in imaging studies, MRI and CAT scans, we are finding more and more ‘incidental’ abnormalities, and there is now a question of ‘what to do’ with such findings.

Some might think that such incidental findings are good fortune to find by accident, so that we can treat the findings and prevent future issues, but as a recent study showed on intervening with a specific type of aneurysm of the brain found on scanning, patients who received such treatment had complications from treatment that suggest these aneurysms are better ‘left alone’.

Of course, treatment in these instances is individualized based on the patient’s situation, but it’s important to understand the limits of our preventive strategies and to keep a cool head, managing such problems in an expectant manner, watching-and-waiting, rather than intervening.

 

 

WE ARE GETTING HEALTHIER…BELIEVE IT!

good news 2This weeks Sunday New York Times had a great article titled “Why Everyone Seems to Have Cancer” and the summary is….as we live longer and reduce the greatest killer of people, HEART DISEASE, Cancer comes to dominate as the major cause of death.

The statistics clearly show reductions in premature death from heart disease and stroke, as well as reductions in death from cancer; only cancer death reductions are less than those seen in heart disease.  Why that is, is the source of great interest, but mostly has to do with the great strides in prevention of heart disease with diet, exercise, and cholesterol medications….and improved treatment of acute illness from stenting, balloon treatments, acute management in the intensive care unit.

Cancer deaths have declined since 1990, mostly due to reduced lung cancer cases, but also as the result of great strides in specific types of childhood and adult cancers, as well as incremental improvements in a whole host of common cancers.

So….the statistics clearly show we are making strides in treating cancer.  Let’s recognize our success but focus on further improvements in the future.